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Evolent Health Associate Director, Market Operations in Boston, Massachusetts

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

As a critical team member providing the 360 degree view of Evolent Health Services (EHS) operations to our health care provider client for administrative tasks delegated to them for their patients - including but not limited to claims processing, audit, customer service, member outreach activities, eligibility and enrollment processes, and finance. The Associate Director will build strong relationships within the client organization and Evolent Health Plan Services while having an exceptionally high service ethic. In addition, the Associate Director will track follow-up items / resolution on key client issues, capture status and meeting minutes, set meeting agendas, along with other routine project management. This colleague also helps track performance against service level agreements (SLA’s) and other key performance indicators (KPI’s).

Reporting Relationship:

  • Associate Director, Market Operations will report to the Director, Market Operations

Principal Accountabilities:

  • Aids Market Operations team and the Director of Market Operations with the development and execution of a strategic value playbook for existing and new health plan partners

  • Ensure Evolent Health is meeting or exceeding service level agreements (SLA’s) and other key operations performance indicators agreed to with the client or as established by the state contract

  • Report on and review operational and process tracking metrics and dashboards with Market Management and the Client, as appropriate.

  • Develop and deliver client-facing content and communication (e.g., resolution plans, status updates, operation changes and next steps), as needed.

  • Maintaining clear view on priority issues for any client and monitoring and managing issues to resolution.

  • Proactively identify and remediate client issues, working with internal departments around claims function, call center metrics, enrollment activities, billing guidelines, provider disputes, compliance issues, and other day-to-day operations

  • Facilitate & participate in internal teamwork with Operations, Technical Operations, Analytics, Finance and/or IT to identify solutions to help drive client issues to successful resolution.

  • Review and evaluate data related to all operations

  • Learning internal operations and seeking out continuous improvement opportunities to enable efficiencies, growth and improved client satisfaction.

  • Ensure strict compliance with federal and state regulations and company policies, procedures and processes.

  • Serves as a liaison to other organizational and market managers, collectively accountable for ensuring successful operation of the responsibilities delegated to Evolent Health by the client under their arrangement.

  • Investigate tickets for themes, root cause of issues, and opportunities to turn the dial in a scalable manner to improve client success

  • Other duties as assigned.

The Experience You’ll Need (Required):

  • Bachelor’s Degree in healthcare, healthcare related discipline or business-related discipline

  • 2-4 years of progressive professional and client-facing background within a health plan, managed care organization, third-party administrator, healthcare provider entity, or provider system

  • Client service orientation

  • Proficiency with Excel

  • Excellent written, computer, and oral communication skills including the ability to develop content rich and visually compelling presentations to convey complex concepts

  • Track record of ownership and tenaciously looking for ways to get results & improve the status quo

Finishing Touches (Preferred):

  • Knowledgeable with Medicaid programs and claims processing is highly preferred

  • Advanced or graduate degree

  • Management level background in Health Plan Administration, Operations, Utilization Management, Care Management, Population Health, and/or Medical Economics

  • Proficiency with analytical tools (e.g. SQL, SAS)

  • Demonstrable stakeholder management expertise and refined consultative analytics approach

  • Proven track record of driving insightful findings from data, preferably in a payer/provider context

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

#LI-Remote

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Compensation Range:

The typical range of employees within the compensation grade of this position is . Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.

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